Document Detail

Subclinical hypothyroidism is linked to micro-inflammation and predicts death in continuous ambulatory peritoneal dialysis.
MedLine Citation:
PMID:  17082213     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Low T3 is a frequent alteration in patients with ESRD. This derangement has been recently linked to inflammation in haemodialysis patients. Whether this association holds true in peritoneal dialysis patients has not been studied. METHODS: We investigated the relationship between low-grade inflammation [IL-6, C-reactive protein (CRP) and serum albumin levels] and free tri-iodothyronine (fT3) in a cohort of 41 CAPD patients (mean age, 66 years; M, 26; F, 15) without heart failure and inter-current illnesses. RESULTS: CAPD patients had lower fT3 levels (2.7 +/- 0.8 pg/ml) than healthy subjects (3.7 +/- 1.0 pg/ml, P < 0.001) of similar age. Free T3 levels were directly related to those of serum albumin (r = 0.52, P = 0.001) and inversely to IL-6 (r = -0.30, P = 0.05) and CRP (r = -0.54, P < 0.001). Age (r = -0.61, P < 0.001), haemoglobin levels (r = 0.32, P = 0.05) and diastolic blood pressure (r = 0.50, P = 0.001) were also related to fT3. In multiple regression models adjusting for all variables related to fT3, CRP and albumin were retained as independent correlates of fT3. During the follow-up (2.8 +/- 1.7 years) 27 patients died. Plasma fT3 levels were lower in patients who died (2.5 +/- 0.8 pg/ml) compared with survivors (3.3 +/- 0.5 pg/ml P = 0.001). In Cox analyses, fT3 was a significant predictor of mortality independent of the main traditional as well as non-traditional risk factors. CONCLUSIONS: The relationship between fT3, CRP and serum albumin suggests that inflammation-malnutrition might be involved in the low T3 syndrome in CAPD patients. Thyroid dysfunction might be implicated in the pathogenic pathway which links micro-inflammation to survival in PD patients.
Giuseppe Enia; Vincenzo Panuccio; Sebastiano Cutrupi; Patrizia Pizzini; Giovanni Tripepi; Francesca Mallamaci; Carmine Zoccali
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Publication Detail:
Type:  Journal Article     Date:  2006-11-02
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  22     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-19     Completed Date:  2007-07-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  England    
Other Details:
Languages:  eng     Pagination:  538-44     Citation Subset:  IM    
CNR-IBIM, Istituto di Biomedicina, Epidemiologia Clinica e Fisiopatologia, delle Malattie Renali e dell'Ipertensione Arteriosa, c/o Ki Point-Gransial Srl, Via Filippini n. 85, 89125 Reggio Calabria, Italy.
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MeSH Terms
C-Reactive Protein / metabolism*
Hypothyroidism / blood,  complications*,  mortality
Inflammation* / blood,  etiology,  mortality
Interleukin-6 / blood
Italy / epidemiology
Kidney Failure, Chronic / mortality,  therapy*
Middle Aged
Peritoneal Dialysis, Continuous Ambulatory / mortality*
Proportional Hazards Models
Risk Factors
Serum Albumin / metabolism
Survival Rate / trends
Triiodothyronine / blood,  deficiency*
Reg. No./Substance:
0/Interleukin-6; 0/Serum Albumin; 6893-02-3/Triiodothyronine; 9007-41-4/C-Reactive Protein

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